Medicare Part B (Medical Insurance) covers insulin if you use an insulin pump that's covered under Part B's durable medical equipment benefit. Part B doesn’t cover insulin pens or insulin-related supplies like:
- Alcohol swabs
Part D covers these:
- Injectable insulin that isn’t used with a traditional insulin pump
- Insulin used with a disposable insulin pump
- Certain medical supplies used to inject insulin, like syringes, gauze, and alcohol swabs
Your costs in Original Medicare
- The cost of a one-month supply of each Part D- and Part B-covered insulin is capped at $35, and you don’t have to pay a deductible for insulin. If you get a 3-month supply of insulin, your costs can't be more than $35 for each month's supply of each covered insulin. This means you'll generally pay no more than $105 for a 3-month supply of covered insulin.
- Under Part D, the $35 cap applies to everyone who takes insulin, even if you get Extra Help.
- If you have Part B and Medicare supplement Insurance (Medigap) that pays your Part B coinsurance, your plan should cover the $35 (or less) cost for insulin.
- For insulin-related supplies (like syringes, needles, alcohol swabs and gauze), you'll pay 100% of the cost under Part B (unless you have Part D).
Things to know
If you use an insulin pump that isn’t disposable, Part B may cover insulin used with the pump and cover the pump itself as durable medical equipment (DME). If you live in certain areas of the country, you may have to use specific insulin pump suppliers for Medicare to pay for a durable insulin pump.